| NPI | 1154779106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 1196) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016021269) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2023-02-20 |